Individual
THERESA ANN TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9411 395TH ST CT E, EATONVILLE, WA 98328-9843
(360) 832-3067
Mailing address
PO BOX 33313, FORT LEWIS, WA 98433-0313
(360) 832-3067
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/26/2019
Last updated
09/26/2019
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